5 Common Causes of Heavy Menstrual Bleeding

Each month, a woman’s uterus increases the thickness of its lining to prepare for a fertilized egg to implant for development. If you don’t release an egg or the released egg isn’t fertilized, the extra tissue and blood slough off and exit through the vagina as part of your period.

Not every woman bleeds the same amount, though. Some deal with heavy menstrual flow and extended periods that lead to pelvic pain and other uncomfortable symptoms.

At Progressive Women's Health OB/GYN in Friendswood and Mission, Texas, Dr. Asia Mohsin and her staff see patients with many types of menstrual-related problems, including heavy flow, formerly termed menorrhagia. 

Here, they discuss some causes of heavy menstrual bleeding and what you can do about it.

What exactly is heavy bleeding?

It’s a little difficult to define “heavy” in this context, as every woman views it differently.

For most women, menstrual bleeding lasts 4-5 days, and the blood loss amounts to no more than about 2-3 tablespoons. However, women with menorrhagia often have periods that last longer than seven days, and they lose twice as much blood.

The best compromise on the definition is: If you bleed for more than seven days per period, or if the flow is heavy enough that you have to change your pad or tampon about every hour, even during the night, you have heavy bleeding and need to see Dr. Mohsin.

You also need to see the doctor if you bleed between periods or bleed vaginally after menopause, if you pass clots larger than a quarter, if you’re weak and short of breath due to the blood loss, or if your cycle disrupts your ability to perform your daily activities. 

5 common causes of heavy menstrual bleeding

Conditions that can lead to heavy menstrual bleeding include:

1. Unbalanced hormones

Usually during a menstrual cycle, there's a balance between the female sex hormones estrogen and progesterone, which controls the buildup of the uterine lining (endometrium). This lining is what’s shed during a menstrual period. 

When the hormones aren’t balanced, the lining thickens too much and sheds by way of heavy menstrual bleeding or bleeding between periods.

Conditions that cause hormone imbalances include obesity, insulin resistance (and Type 2 diabetes), thyroid problems, and polycystic ovary syndrome (PCOS).

2. Problems with the ovaries

The ovaries don’t always release an egg during a menstrual cycle, a condition known as anovulation. 

When anovulation occurs, the body doesn't make progesterone the way it does during a typical menstrual cycle. That leads to a hormonal imbalance and can cause heavy menstrual bleeding or unexpected bleeding between periods.

3. Uterine fibroids

Fibroids are benign tumors that develop during a woman’s childbearing years. They may lead to heavier than normal menstrual bleeding or bleeding for an extended period.

4. Polyps

These small, noncancerous growths form on the lining of the uterus and may cause heavy or protracted menstrual bleeding. Polyps can also cause bleeding between periods or spotting/bleeding after menopause.

5. Intrauterine device (IUD)

If you use a hormone-free IUD for birth control, one of the primary side effects is heavy menstrual bleeding. Speak with Dr. Mohsin about your other birth control options. If you want to stick with an IUD, those with progestin may ease heavy menstrual bleeding.

If you’re struggling with the pain and discomfort of heavy menstrual flow, Progressive Women’s Health OB/GYN has treatments that can help. To learn more or schedule a consultation, call the office nearest you or book online today. We also offer telehealth appointments.